Inflammatory Intestinal Diseases最新文献

{"title":"Evolution of Growth following Anti-Tumor Necrosis Factor-α Therapy in Paediatric Crohn's Disease: Data from the Swiss IBD Cohort Study.","authors":"Cléa Kunz, Alain Schoepfer, Christiane Sokollik, Mathilde Crédeville, Vasikili Spyropoulou, Franziska Righini Grunder, Michela G Schaeppi Tempia, Henrik Köhler, Andreas Nydegger","doi":"10.1159/000548730","DOIUrl":"10.1159/000548730","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 85% of pediatric patients affected by Crohn's disease experience growth failure. This study aims to elucidate the effects of anti-tumor necrosis factor (TNF) biologics on patient growth.</p><p><strong>Methods: </strong>This retrospective analysis examined height, height velocity and weight in pediatric patients with Crohn's disease from the Swiss Inflammatory Bowel Disease Cohort Study between 2007 and 2020 (<i>n</i> = 97)<i>.</i> Z-scores were determined according to age and gender of a healthy pediatric population. Growth of patients treated with anti-TNF biologics and immunomodulators was analyzed by linear regression over 5 years and compared within each subgroup by paired Student <i>t</i> tests 1 year (T1), 2 years (T2), and 5 years (T5) after treatment initiation.</p><p><strong>Results: </strong>Mean height and weight z-scores at diagnosis were -0.3 ± 1.3 and -1.0 ± 1.6, respectively (age at diagnosis 11.1 ± 2.7 years, 52.0% male). Initial treatment was led by azathioprine (58.3%) and infliximab (19.8%). Patients treated with biologics exhibited significant height increase at T1 (<i>p</i> = 0.022), with an overall flat height evolution (<i>y</i> = 0.00<i>x</i> - 0.31), whereas significant weight increase was maintained at T5 (<i>p</i> = 0.0005, <i>y</i> = 0.13<i>x</i> - 0.50). Patients on immunomodulators showed a height increase (<i>y</i> = 0.15<i>x</i> - 0.20) and a significant weight increase at T2 (<i>p</i> = 0.0047, <i>y</i> = 0.10<i>x</i> - 0.41). Height velocity z-scores showed a significant increase across both genders. Factors contributing to a decreased height z-score included male sex, age 10 and below at diagnosis, a concomitant corticosteroid treatment and a top-down treatment strategy.</p><p><strong>Conclusion: </strong>Our findings indicate that anti-TNF biologics are associated with significant short-term height and long-term weight gains in pediatric patients with Crohn's disease, similar to those observed with immunomodulators.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"347-358"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Calprotectin Levels in Post-Metabolic Bariatric Surgery Patients: A Retrospective Study.","authors":"Fenna M M Beeren, Britt Roosenboom, Marcel B W Spanier, Marcel J M Groenen, Peter D Siersema","doi":"10.1159/000548160","DOIUrl":"10.1159/000548160","url":null,"abstract":"<p><strong>Introduction: </strong>Fecal calprotectin (FCP) is a key biomarker for gastrointestinal inflammation, aiding in differentiating irritable bowel syndrome from active inflammatory bowel disease (IBD). Metabolic bariatric surgeries (MBSs), such as Roux-en-Y gastric bypass or sleeve gastrectomy, alter gastrointestinal physiology, potentially affecting the applicability of standard FCP cutoff values in this population.</p><p><strong>Methods: </strong>This retrospective study included 340 patients who underwent MBS and subsequent FCP testing between January 2000 and June 2024. Patients with preoperative IBD were excluded. The primary outcome was to identify the optimal FCP cutoff values for relevant colonoscopy findings. Secondary outcomes included median FCP levels, colonoscopy results, and subgroup analyses based on sex, surgery type, and time to gastrointestinal evaluation.</p><p><strong>Results: </strong>The median FCP level across all patients was 51 µg/g (IQR 30-82). Among 124 patients undergoing colonoscopy, the median FCP was 61 µg/g (IQR 34-104). There was no significant difference between patients with (69.5 µg/g, <i>n</i> = 50) or without (59 µg/g, <i>n</i> = 74) relevant findings, including malignancy or IBD (<i>p</i> = 0.101). No significant differences in FCP levels were observed between subgroups based on cholecystectomy status, biliopancreatic limb length, types of surgery, body mass index, time to presentation since MBS, or proton pump inhibitor use. ROC analysis identified an optimal cut off of 59.5 µg/g (sensitivity: 64.6%; specificity: 63.4%; area under the curve: 0.653; Youden's index 0.280).</p><p><strong>Conclusion: </strong>In patients following MBS, the optimal FCP cutoff value would be at 59.5 µg/g. However, given the low Youden's index and the minimal difference compared to the standard cutoff value of 50 µg/g, maintaining this standard, seems more practical in clinical settings.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"329-336"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-Reactive Protein Levels in Patients with Isolated Inflammatory Bowel Disease (Crohn's Disease and Ulcerative Colitis) and Coexisting <i>H. pylori</i> Infection and IBD: A Comparative Study.","authors":"Abdullah D Alotaibi","doi":"10.1159/000548449","DOIUrl":"10.1159/000548449","url":null,"abstract":"<p><strong>Introduction: </strong>The association with <i>Helicobacter pylori</i> infection and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is conflicting, with the former studies reporting a protective effect while others report increased inflammation. This study examines the effect of <i>H. pylori</i> infection on systemic inflammation - C-reactive protein levels - among IBD patients.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted at Imam Abdulrahman Bin Faisal University Hospital, Al Khobar, Saudi Arabia, by reviewing the electronic medical records of 630 patients diagnosed with <i>H. pylori</i> infection, CD, or UC from January 2020 to December 2024. The levels of CRP were measured with a turbidimetric immunoassay of high sensitivity and categorized as normal or less than or equal to 1 mg/dL, moderate with a value of 1-10 mg/dL, or raised if the value is above 10 mg/dL. Kruskal-Wallis and Mann-Whitney U tests were used for statistical comparisons of CRP levels between groups.</p><p><strong>Results: </strong>Mean CRP levels were highest in <i>H. pylori</i>-positive CD patients (12.69 mg/dL), UC patients (11.18 mg/dL), compared to <i>H. pylori</i>-negative matches (6.74 mg/dL for CD and 4.55 mg/dL for UC). The <i>H. pylori</i>-only group had the lowest average in CRP (2.62 mg/dL). Differences in patient categories were significant (<i>p</i> < 0.001); CD had 50% cases with elevated CRP, 40% for UC, and 60% for moderate elevations in <i>H. pylori</i>-only patients.</p><p><strong>Conclusion: </strong><i>H. pylori</i> infection is also accompanied by higher systemic inflammation in IBD, specifically in CD, characterized by high CRP.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"318-328"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Mesalazine and Ozanimod following Induction Treatment in Mesalazine-Exposed Advanced Therapy-Naïve Adult Ulcerative Colitis Patients.","authors":"Geert D'Haens, Ekaterina Safroneeva, Laurent Peyrin-Biroulet, Silvio Danese, Vipul Jairath, Helen Thorne, Raphaël Laoun","doi":"10.1159/000548243","DOIUrl":"10.1159/000548243","url":null,"abstract":"<p><strong>Introduction: </strong>Both mesalazine and ozanimod are oral treatment options for patients with moderately active ulcerative colitis (UC).</p><p><strong>Methods: </strong>Comparative analysis comparing efficacy endpoints of an 8-week non-inferiority induction study (TP0503) with 3.2 g/day mesalazine (<i>n</i> = 321) to the True North 10-week induction study of 1 mg/day ozanimod (<i>n</i> = 281). We compared the efficacy of oral mesalazine (Asacol) as monotherapy and ozanimod (Zeposia) as add-on therapy to mesalazine, without concomitant corticosteroids, following induction treatment in mesalazine-exposed but immunomodulator- and advanced therapy-naïve UC patients. Endpoints from the non-inferiority study were re-calculated using the definitions from the True North study.</p><p><strong>Results: </strong>The two cohorts had similar age (45 ± 14 years vs. 44 ± 13.5 years) and baseline disease severity (total Mayo score; 8.5 ± 0.8 vs. 8.6 ± 1.1) for mesalazine- and ozanimod-treated patients, respectively. No differences were observed in patients achieving clinical response (reduction from baseline in the 3-component Mayo score [sum of rectal bleeding subscore/RBS, stool frequency subscore/SFS, and Mayo endoscopic score/MES) of ≥2 points and ≥35%, and a reduction from baseline in the RBS of ≥1 point or an absolute RBS ≤1} (58% vs. 58%; <i>p</i> = 0.917) and clinical remission (RBS = 0, SFS ≤1 [and decreases of ≥1 point from baseline SFS], and MES ≤1) (22% vs. 28%; <i>p</i> = 0.074) treated with mesalazine (at 8 weeks) and ozanimod (at 10 weeks), respectively. A higher percentage of patients treated with ozanimod achieved endoscopic improvement (MES ≤1 without friability) compared to mesalazine (38% vs. 29%, <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>Among individuals previously exposed to mesalazine, a similar effect on clinical efficacy was observed between patients treated with mesalazine and those treated with ozanimod.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"337-346"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Early Phase 2 Double-Blind, Placebo-Controlled Study of E6011, a Novel Anti-Fractalkine Antibody, in Patients with Crohn's Disease.","authors":"Taku Kobayashi, Toshifumi Hibi, Mamoru Watanabe, Gerhard Rogler, Hiroaki Ohishi, Shinsuke Kurosu, Katsuyoshi Matsuoka","doi":"10.1159/000548232","DOIUrl":"10.1159/000548232","url":null,"abstract":"<p><strong>Introduction: </strong>E6011 is a newly developed humanized monoclonal antibody that binds to and neutralizes fractalkine with high specificity and affinity. In a previous phase 1, open-label study, E6011 demonstrated good tolerability and preliminary efficacy in Japanese patients with mild to moderate active Crohn's disease (CD).</p><p><strong>Methods: </strong>In this early phase 2, double-blind, placebo-controlled study, we examined the efficacy and safety of E6011 in patients with moderate to severe active CD in a 12-week, double-blind period and the long-term efficacy and safety of E6011 in a subsequent open-label period for a maximum of 52 weeks. The primary efficacy endpoint was the percentage of patients who achieved a decrease in the CD activity index (CDAI) by ≥100 points from baseline at week 12.</p><p><strong>Results: </strong>Of the planned 40 participants, enrollment was closed after 25 had been enrolled, primarily because of the delay in patient enrollment during the COVID-19 pandemic. A decrease in CDAI by ≥100 points was achieved in 33.3% (4/12) in the E6011 group and 23.1% (3/13) in the placebo group at week 12, resulting in a posterior difference of 9.6% (95% credible interval -23.7% to 42.7%). The probability of the difference between groups being ≥25% was 18.3%, which did not exceed the prespecified threshold of 50%. E6011 was safe and well tolerated in the 12-week, double-blind period. No new safety issues were reported in patients treated until week 40.</p><p><strong>Conclusion: </strong>E6011 was safe and well tolerated in patients with moderate to severe active CD. Owing to the small sample size in this study, further studies are necessary to accurately evaluate its efficacy.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"306-317"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and Preconception Care for Patients with Inflammatory Bowel Disease.","authors":"Namiko Hoshi, Yuna Ku, Makoto Ooi","doi":"10.1159/000548156","DOIUrl":"10.1159/000548156","url":null,"abstract":"<p><strong>Background: </strong>For both men and women, family planning, including decisions regarding marriage and childbearing, is a significant life event that contributes to overall \"happy life.\" Patients with chronic diseases such as inflammatory bowel disease face not only concerns about common pregnancy-related complications but also disease-specific challenges, including the potential effects of medications on the fetus and the risk of disease exacerbation during pregnancy. In response to these concerns, patients may occasionally make misguided decisions, such as the self-discontinuation of necessary treatment, increasing the risk of adverse health outcomes for both maternal health and fetal development.</p><p><strong>Summary: </strong>Preconception care aims to address these concerns by providing guidance to mitigate factors that may negatively impact maternal and fetal health. This includes optimizing behavioral, personal, and environmental determinants of health. In this review article, we discuss the role of preconception care in supporting an optimized pregnancy, safe delivery, and healthy postpartum period for the patients wishing to have babies.</p><p><strong>Key messages: </strong>Proper preconception counseling can improve the pregnancy outcomes. Healthcare professionals play a crucial role in preconception care by providing patients with accurate medical knowledge and guidance, enabling them to make informed decisions and ensuring a safe and well-prepared pregnancy and childbirth.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"290-303"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological Predictors for Therapeutic Response to Integrin Inhibitors in Patients with Ulcerative Colitis.","authors":"Takuya Kimizuka, Atsushi Yoshida, Fumiaki Ueno, Yutaka Endo, Yo Kato, Katsuyoshi Matsuoka, Tadakazu Hisamatsu, Toshifumi Hibi","doi":"10.1159/000547013","DOIUrl":"10.1159/000547013","url":null,"abstract":"<p><strong>Introduction: </strong>It is crucial to predict the effectiveness of advanced therapies before their administration in ulcerative colitis (UC). Only a few studies have revealed predictive histological factors. Here, we sought to determine whether conventional histology of pretreatment endoscopic biopsy specimens can predict the response to integrin inhibitors.</p><p><strong>Methods: </strong>In the present single-center retrospective study, we examined histopathological findings before initiating an integrin inhibitor. Primary response (PR) was defined as a ≥3-point decrease in the partial Mayo score at 14 weeks. Logistic regression was used to identify the factors predictive for a PR.</p><p><strong>Results: </strong>We analyzed 21 biological and Janus kinase inhibitor-naïve patients with UC. The median baseline Mayo score was 7 (IQR, 6-8), and the C-reactive protein was 0.36 (IQR, 0.11-0.74). Histological findings included large lymphoid follicles (LF) in 61.9% (13/21), basal plasma cell infiltration in 52.4% (11/21), and eosinophilic infiltration (EO) in 42.9% (9/21). PR at 14 weeks was achieved in 57.1% (12/21). Among PR patients, LF was present in 91.7% (11/12), BP in 41.7% (5/12), and EO in 25.0% (3/12). PR was observed in 76.9% (10/13) of LF-positive patients vs. 12.5% (1/8) of LF-negative patients (<i>p</i> = 0.01). LF was significantly associated with the response to integrin inhibitors, whereas BP and EO were not.</p><p><strong>Conclusion: </strong>The presence of LF in biopsy specimens predicts the response to integrin inhibitors in patients with UC. Conventional histological examinations may aid in predicting therapeutic responses to advanced therapies.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"224-232"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Data on the Effectiveness of Ustekinumab and Risankizumab for Crohn's Disease.","authors":"Ryo Morikawa, Toshimitsu Fujii, Akiko Tamura, Ami Kawamoto, Shuji Hibiya, Kento Takenaka, Hiromichi Shimizu, Kazuo Ohtsuka, Ryuichi Okamoto","doi":"10.1159/000547048","DOIUrl":"10.1159/000547048","url":null,"abstract":"<p><strong>Introduction: </strong>No real-world studies have compared efficacy of ustekinumab (UST) and risankizumab (RZB) for the treatment of Crohn's disease (CD).</p><p><strong>Methods: </strong>We retrospectively collected the data of patients with CD treated with UST or RZB between May 2017 and March 2024 at the Institute of Science Tokyo and analyzed clinical remission rate at weeks 8 and 28 using Harvey-Bradshaw Index (HBI), with remission defined as a HBI ≤4.</p><p><strong>Result: </strong>A total of 111 patients who were treated with UST and 29 patients treated with RZB were included in the analysis. RZB had higher efficacy both at weeks 8 (82.8% vs. 62.2%, <i>p</i> = 0.0465) and 28 (79.3% vs. 56.8%, <i>p</i> = 0.0321) than UST in the full study cohort, and at weeks 8 (55.6% vs. 18.4%, <i>p</i> = 0.0352) and 28 (66.7% vs. 18.4%, <i>p</i> = 0.0083) in the patients with clinically active disease and anti-TNFα exposed patients. During the observation period, 1 patient with RZB (3.45%) experienced an adverse event that required hospitalization, and 1 patient in the UST group (0.900%) experienced an adverse event that led to treatment discontinuation.</p><p><strong>Conclusion: </strong>RZB may offer greater short-term efficacy than UST, with an acceptable safety profile in real-world settings.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"285-289"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Oral Budesonide after Endoscopic Balloon Dilation in Patients with Crohn's Disease: A Multicenter Prospective Intervention Study.","authors":"Yuriko Otake-Kasamoto, Takeo Yoshihara, Shinichiro Shinzaki, Takuya Yamada, Hiroyuki Ogawa, Yuko Sakakibara, Satoshi Hiyama, Yuri Tsujii, Akiko Asakura, Taku Tashiro, Takahiro Amano, Mizuki Tani, Ryotaro Uema, Yoshiki Tsujii, Takahiro Inoue, Hideki Iijima, Yoshito Hayashi, Tetsuo Takehara","doi":"10.1159/000547608","DOIUrl":"10.1159/000547608","url":null,"abstract":"<p><strong>Introduction: </strong>Budesonide, with its high topical steroidal activity, effectively prevents strictures following esophageal endoscopic treatment. However, its effectiveness in preventing restenosis after endoscopic balloon dilation (EBD) in patients with Crohn's disease (CD) remains unclear. We aimed to evaluate the safety and effectiveness of oral budesonide after EBD in patients with CD.</p><p><strong>Methods: </strong>We conducted a multicenter prospective study of patients with CD who underwent EBD at the University of Osaka and its affiliated hospitals between March 2018 and March 2023 (UMIN000031839, jRCT1051190043). Oral budesonide was administered for 4 weeks after EBD, and patients were followed up for 52 weeks. Safety and effectiveness within 12 and 52 weeks of the procedure were evaluated, with endoscopic evaluation of restenosis at week 52. The stenosis diameter and length were estimated endoscopically and radiographically, respectively. In the historical control study, consecutive patients with CD who underwent EBD between February 2016 and July 2018 were included. The incidence rates of obstructive symptoms and hospitalization at 52 weeks after EBD were retrospectively investigated from the medical records.</p><p><strong>Results: </strong>Overall, 15 patients were analyzed (male, 14 [93.3%]; median age, 44 years [37-49]; disease type, L1, 8 [53.3%]/L3, 7 [46.7%]; stenosis location, jejunum, 1 [6.7%]/ileum, 8 [53.3%]/ileocolonic, 6 [40.0%]; median stenosis diameter, 5 mm [5-6]). No serious complications were observed within 12 or 52 weeks. Twelve (80%) patients showed no symptoms of stenosis within 52 weeks. Of the 14 patients who underwent an endoscopy at week 52, re-EBD was not required in 3 patients (21.4%). The stenosis diameter at week 52 improved significantly compared to the pre-dilation measurements (<i>p</i> = 0.004). Furthermore, the 15 patients treated with budesonide had a significantly lower incidence rates of obstructive symptoms and hospitalization compared to the 19 historical control patients (<i>p</i> = 0.020 and 0.035, respectively).</p><p><strong>Conclusion: </strong>Budesonide administration after EBD can be safely performed in patients with CD and may be effective in preventing restenosis and avoiding hospitalization and intestinal surgery.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"254-264"},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of IL-12/23 and IL-23 Inhibitors for Induction and Maintenance Therapy in Moderate-to-Severe Crohn's Disease: A Systematic Review and Network Meta-Analysis.","authors":"Mohammad Al Hayek, Bisher Sawaf, Mohammed S Beshr, Ahmad Kassem, Dahham Alsoud, Mulham Alom, Rana H Shembesh, Abdelaziz H Salama, Yusuf Hallak, Shahem Abbarh, Elias Batikh, Mosa Shibani, Muhammed Elhadi, Anita Afzali, Miguel Regueiro","doi":"10.1159/000547707","DOIUrl":"10.1159/000547707","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin (IL)-12/23 and IL-23 inhibitors have emerged as promising therapeutic options for moderate-to-severe Crohn's disease (CD), but comparative data between agents remain limited. This study aimed to assess and rank the efficacy of IL-12/23 and IL-23 inhibitors across key clinical and endoscopic outcomes using network meta-analysis.</p><p><strong>Methods: </strong>We included randomized controlled trials (RCTs) evaluating IL-12/23 (ustekinumab) and IL-23 inhibitors (risankizumab, mirikizumab, guselkumab, briakinumab, and MEDI2070) versus placebo or each other in adult patients with moderate-to-severe CD. Primary outcomes included clinical and endoscopic remission (assessed at the end of the induction and maintenance phases) and corticosteroid-free clinical remission (assessed at the end of the maintenance phase). Risk ratios (RRs) were estimated using a random-effects model. All analyses were conducted in R using the netmeta package. Surface under the cumulative ranking curve (SUCRA) analysis was used to rank treatments across these endpoints.</p><p><strong>Results: </strong>Fourteen RCTs involving 4,464 patients during the induction phase and 2,601 patients during the maintenance phase were included. Guselkumab achieved the highest clinical remission rate compared to placebo at the end of both the induction phase (RR = 2.62; 95% confidence interval [CI], 2.03-3.39; SUCRA: 91%) and the maintenance phase (RR = 2.37; 95% CI, 1.64-3.42; SUCRA: 85%). In addition, guselkumab was superior to mirikizumab in terms of clinical remission at the end of the induction phase (RR = 1.66; 95% CI, 1.16-2.37). Guselkumab was also the most effective agent for achieving corticosteroid-free clinical remission compared to placebo (RR = 3.06; 95% CI, 1.52-6.16; SUCRA: 78%) at the end of the maintenance phase. Mirikizumab achieved the highest endoscopic remission rate compared to placebo at the end of both the induction phase (RR = 3.52; 95% CI, 1.50-8.27; SUCRA: 78%) and the maintenance phase (RR = 5.84; 95% CI, 2.76-12.37; SUCRA: 88%). Furthermore, mirikizumab, guselkumab, and risankizumab were superior to ustekinumab in terms of endoscopic remission at the end of the maintenance phase.</p><p><strong>Conclusions: </strong>These findings suggest that guselkumab may be a potential first-line therapy for patients presenting with predominant clinical symptoms, offering the additional benefit of reducing corticosteroid use and its associated long-term risks. Conversely, mirikizumab may be the preferred option for patients with persistent mucosal inflammation, owing to its superior efficacy in achieving endoscopic remission.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"265-284"},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}